Operating steam sterilizers can be tricky at times, so your best bet is to consult the manufacturers instructions, since each machine is unique. Still you’re bound to run into a few questions that will go unanswered.
Luckily we’ve got some answers. Below are a three questions that healthcare professionals run into most often, along with a few online resources if you need a reference point.
Can we sterilize by flash steam sterilization screws that will be implanted in an orthopedic total knee replacement?
Flash sterilization should not be used for implantable devices except in cases of emergency when no other option is available. In an emergency, when flash sterilization of an implant is unavoidable, a rapid-action biological indicator with a Class 5 chemical integrating indictor should be run with the load. The implant should then be quarantined on the back table and should not be released until the rapid action biological indicator provides a negative result. Many facilities will report flash sterilization of implants as an “incident” and trend reporting back to their infection control committees.
I work in a small physician office where we only use our steam sterilizer once or so every couple of weeks. Do I need to run the autoclave more often to test the effectiveness of our machine?
No, AAMI ST 79 only recommends that you test effectiveness of the steam sterilizer when it is in use. They suggest weekly, preferably daily monitoring with a biological indicator, plus on all loads containing an implant if the equipment is used during those time periods. So, you would be in compliance to this guideline if you used a biological indicator each time with every sterilizer load. As always, with any equipment, one should check the manufacturer’s protocols for use.
We have an old steam sterilizer in our office. How do I know it is running effectively?
It is very important that you contact the manufacturer of the sterilizer and get a copy of the manufacturer’s owner’s manual and make sure that you are following the recommendations on how to run the equipment. If the directions are not obtainable, the equipment should be scrapped! As always, rapid response biological indicators should be used at least weekly and preferably daily on sterilizers in an office setting.
3M: Sterile U  – In case you didn’t know, 3M makes more than just scotch tape. Their site, “Sterile U,” provides excellent resources including training tips, interpretations, and general advice for all kinds of sterilizers. The best part: registration is free.
Steam Online  – This site bills itself as a “community of industrial steam users.” Here you’ll find a directory of vendors, a knowledge center, and glossary as well as articles, tables, and formulas.
Sterilization Answer Man  – Thomas K. “Chip” Moore, feature in the December issue of Medical Environment Update offers real time answers to your sterilization questions. You can call or email him about anything from techniques to standards to biological tests.
CDC Guidelines  – As noted in this blog space earlier, after many years of anticipation, the CDC has released guidelines on sterilization that are in compliance with AMSI standards. The 158-page document is a complete reference guide for all your sterilization needs.
AAMI  – It makes sense that the organization that created the sterilization standards would be a good resource. The Association for the Advancement of Medical Instrumentation (AAMI) offers everything you need in the way of standards and interpretations. The only downfall: you have to pay for it. But if you are finding the need to refer to the standards on a daily basis, their publications are a must-have.
Steris  – This is an all-in-one site where you can buy products, as well as get advice and consultation. Their area of expertise is all things involved with infections control including sterilization.